Objective:To analyze the risk factors for progression of visual field defects after micropulse laser trabeculoplasty (MLT) in patients with open-angle glaucoma. Methods:Ninety patients (180 eyes) with primary open-angle glaucoma (POAG) who underwent MLT between January 2024 and January 2025 were selected. Based on progression of visual field defects at one year post-surgery, they were assigned to the progression group and the non-progression group. Clinical data of the two groups were collected and compared. Logistic regression was used to analyze the risk factors for progression of visual field defects after MLT. Results:No significant differences were found between the two groups in terms of gender, age, place of residence, body mass index (BMI), education level, drinking history, hypertension, smoking history, family history of glaucoma, history of glaucoma surgery, preoperative highest intraocular pressure, types of preoperative medications, status of cataract surgery, LogMAR visual acuity, central corneal thickness (CCT), and axial length (all P>0.05). The proportions of patients with diabetes, preoperative visual field stage 0-3, and severe damage in both superior and inferior retinal nerve fiber layers (RNFL) were significantly higher in the progression group than in the non-progression group (all P<0.05). Diabetes, preoperative visual field stage 0-3, and severe damage in both superior and inferior RNFL were risk factors for progression of visual field defects after MLT in patients with POAG (all P<0.05). Conclusion:Diabetes, preoperative visual field stage 0-3, and severe damage in both superior and inferior RNFL are main risk factors for progression of visual field defects after MLT in patients with POAG, which deserves close attention in clinical practice.